背景:抑郁症与环境烟草烟雾(ETS)和炎症有关。然而,全身性炎症是否介导ETS-抑郁关系尚不清楚.
方法:我们分析了2009-2018年国家健康和营养检查调查的19,612名参与者(代表约206,284,711名美国人)。利用抑郁症状的数据(通过患者健康问卷-9评估),血液可替宁水平(ETS生物标志物),膳食炎症指数(DII,通过24小时饮食回忆评估)和炎症,以免疫炎症指数(SII)和全身炎症反应指数(SIRI)为代表。
结果:加权多变量逻辑回归显示,较高的血液可替宁水平与较高的抑郁症状风险显着相关(OR=1.79,1.35-2.38)。在调整协变量后,吸烟者的影响(OR=1.220,95%CI:1.140-1.309)大于非吸烟者的影响(OR=1.150,95%CI:1.009-1.318)。与最低水平相比,SII水平最高的参与者的抑郁症状风险,SIRI和DII为19%(OR=1.19,1.05-1.35),提高15%(OR=1.15,1.01-1.31)和88%(OR=1.88,1.48-2.39),分别。加权线性回归表明SII呈正相关(β=0.004,0.001-0.006),SIRI(β=0.009,0.005-0.012)和DII(β=0.213,0.187-0.240)与血液可替宁水平。限制性三次样条模型显示血液可替宁和抑郁症状之间的线性剂量反应关系(Pnon-linear=0.410),降低DII的风险。SII和SIRI分别介导血液可替宁与抑郁症状之间的相关性的0.21%和0.1%。
结论:横截面设计,缺乏抑郁症的药物数据。
结论:ETS(血可替宁)与抑郁症状风险的正相关部分由全身性炎症介导,抗炎饮食可能是有益的。
Depression is associated with both environmental tobacco smoke (ETS) and inflammation. However, whether systemic inflammation mediates the ETS-depression relationship is unclear.
We analyzed 19,612 participants from the 2009-2018 National Health and Nutrition Examination Survey (representing approximately 206,284,711 USA individuals), utilizing data of depressive symptoms (assessed by Patient Health Questionnaire-9), blood cotinine level (an ETS biomarker), dietary inflammatory index (DII, assessed by 24-h dietary recall) and inflammation, represented by immune-inflammation index (SII) and systemic inflammation response index (SIRI).
Weighted multivariable logistic regression showed that a higher blood cotinine level is significantly associated with a higher depressive symptoms risk (OR = 1.79, 1.35-2.38). After adjusting for covariates, the effect in smokers (OR = 1.220, 95 % CI: 1.140-1.309) is larger than that in non-smokers (OR = 1.150, 95 % CI: 1.009-1.318). Compared to the lowest level, depressive symptoms risks in participants with the highest level of SII, SIRI and DII are 19 % (OR = 1.19, 1.05-1.35), 15 % (OR = 1.15, 1.01-1.31) and 88 % (OR = 1.88, 1.48-2.39) higher, respectively. Weighted linear regression demonstrated positive correlations of SII (β = 0.004, 0.001-0.006), SIRI (β = 0.009, 0.005-0.012) and DII (β = 0.213, 0.187-0.240) with blood cotinine level. Restricted cubic splines model showed a linear dose-response relationship between blood cotinine and depressive symptoms (Pnon-linear = 0.410), with decreasing risk for lower DII. And SII and SIRI respectively mediate 0.21 % and 0.1 % of the association between blood cotinine and depressive symptoms.
Cross-sectional design, and lack of medication data for depression.
Positive association of ETS (blood cotinine) with depressive symptoms risk is partly mediated by systemic inflammation, and anti-inflammatory diet could be beneficial.